The NEA research team has published its latest paper on the out-of-pocket (OOP) costs of atopic dermatitis (AD) in the U.S. — this time examining OOP costs among caregivers of children with AD compared to adults.
Published On: Jan 31, 2022
Last Updated On: Sep 27, 2022
In observance of American Heart Month, we connected with Dr. Anna Ascott, with the London School of Hygiene & Tropical Medicine, about the potential link between heart disease and atopic dermatitis (AD). As recently as 2018, emerging research in the British Medical Journal demonstrated that people with severe AD had a 40% increased risk of heart attack and atrial fibrillation; 70% greater risk of heart failure; and 20% higher risk of stroke.
In further exploration of this subject, Dr. Ascott and her fellow researchers reviewed 19 different studies on eczema and cardiovascular risks. With this meta-analysis, Ascott and fellow researchers found that risks of cardiovascular disease and certain cardiovascular events increased depending on the seriousness of a person’s eczema symptoms. Their results were published in The Journal of Allergy and Clinical Immunology. Specifically, the scientists found that severe eczema was associated with increased risk of angina (chest pain caused by inadequate blood to the heart), heart failure, myocardial infarction (heart attack) and cardiovascular-related death.
“In our research,” said Ascott, “we found that people with severe atopic eczema were more likely to develop cardiovascular diseases than people with milder forms of atopic eczema. This was also true for people who had atopic eczema that was active more regularly compared to those who only had active atopic eczema some of the time.” Ascott speculated that the reasons for this may be that a person with more severe and active eczema has more inflammation in the body and that increased inflammation increases the chances of developing cardiovascular problems, as is seen with other other inflammatory conditions, like rheumatoid arthritis.
If this sounds like a lot to process, don’t worry. “The good news,” said Ascott, “is that although people with moderate and severe atopic eczema are at higher risk of heart disease, the overall risk is low. When we combined existing studies together, we found that the risk of developing angina, heart attack, heart failure, stroke or cardiovascular death was 15% greater in people with moderate atopic eczema and 32% greater in people with severe atopic eczema, compared to people with mild atopic eczema.”
There is not yet data to tell us exactly why or how severe eczema is associated with cardiovascular risks, but there are some theories. As Ascott mentioned, other inflammatory conditions have been linked to cardiovascular disease; people with eczema typically have weaker skin barriers which can lead to more skin infections and, in turn, greater overall inflammation. Another theory is that platelet dysfunction and differences in fibrin and clotting in patients with eczema could be a factor. Ascott noted, too, that certain treatments for eczema could impact cardiovascular risks.
“Oral corticosteroids,” she said, “in short courses can be very helpful for patients. But if oral corticosteroids are used long term they have many side effects including increasing blood pressure and cholesterol, and increasing the risk of diabetes and obesity, all of which lead to cardiovascular diseases.”
Given these links between severe eczema and cardiovascular conditions, should we be taking better care of eczema for heart-health reasons? Based on the limited research so far, Ascott is not yet sure.
“This is a really important question,” she said. “Some studies in other diseases have looked at what happens if inflammation is reduced with treatments and have found that the likelihood of developing cardiovascular diseases does reduce, but we need to do more research on this topic with atopic eczema.”
Of course, when it comes down to it, everyone should be looking after their hearts as well as their skin. According to the CDC, heart disease is the leading cause of death for men, women and people of most racial and ethnic groups in the United States.
1. Most important: talk to your doctor about your heart health. If you have severe eczema, eczema that covers a large portion of your body, if your eczema is difficult to manage, or if your eczema flares for extended periods of time, ask your doctor about your heart health and whether there are any additional health risks you should consider.
2. Have your blood pressure checked regularly. This is likely already a part of your check-ups, but if not, or if you aren’t having check-ups, now’s the time to get into a routine. If push comes to shove, you can measure your blood pressure at certain pharmacies, as long as you follow up with a doctor about any concerning results. The U.S. Department of Health and Human Services says we should all be getting our blood pressure measured “regularly” after the age of 18. People at higher risk are recommended to have blood pressure taken once a year. What’s considered higher risk? You’re at increased risk for high blood pressure if you:
3. Monitor your cholesterol. Some pharmacies can also do cholesterol lab work. Again, please be sure to consult with a healthcare provider about your results. The CDC says that most healthy adults should have their cholesterol measured every four to six years. But if you have severe eczema, you probably want to consider having it reviewed more often. Children and adolescents should have their cholesterol checked at least once between ages 9 and 11 and again between ages 17 and 21.
4. Follow heart-healthy guidelines from the National Heart, Lung and Blood Institute:
5. Be aware of the warning signs of heart conditions and get immediate medical help when you need it. Symptoms of a heart attack or another cardiovascular problem can include:
Not everyone is cognizant — not yet at least! — that there’s a connection between severe eczema and heart health, but now you are. We hope you use this information to advocate for yourself, your loved ones and heart health this month and every month.
As always, we ❤ you.